No expectation of labour

Last Thursday Frenchwoman Veronique Courjault, who strangled three of her newborn babies and stored two of them in the family…

Last Thursday Frenchwoman Veronique Courjault, who strangled three of her newborn babies and stored two of them in the family freezer, was jailed for eight years. SHEILA WAYMANlooks at the issue of 'pregnancy denial' which was used during her defence

WHEN NOREEN Collins* walked into the AE department of a Waterford hospital with abdominal pains at 9.30am on June 26th last year and told staff she thought she was nine months pregnant: it was the first time she had really admitted to herself that she was having a baby.

Despite feeling cramps for much of the previous day, she had finished her shift in a bar at 2am that morning. She told colleagues she wasn’t feeling well and that she thought it was a kidney infection.

“I kind of knew what it was but I was trying to convince myself it was a kidney infection,” she says. “I kept pushing it out of my mind; it can’t be that.” She had very little bump showing.

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Two and a half hours after Noreen arrived in the hospital, she gave birth to a baby girl, who was full term but weighed just 5lb 3oz (2.34kg). Of the labour, she says she was physically and emotionally drained.“I was not with it at all. I was in my own little bubble,” she recalls. “It was a huge shock.”

Cases such as this, where women attend hospital very late to deliver a baby, or have an unassisted birth elsewhere, is a recognised phenomenon known as “concealed pregnancy”. In Ireland, an estimated one in every 403 births in a rural maternity hospital is concealed, compared with one in every 625 births at a Dublin maternity hospital, according to a 2006 report, published by the Crisis Pregnancy Agency and HSE West.

In this study, concealed pregnancy is defined as one not disclosed until after at least 20 weeks gestation.

There are three types of concealed pregnancy: conscious denial, in which a woman recognises she is pregnant but continues to deny it to herself and others. Concealment of pregnancy, where a woman acknowledges the pregnancy to herself but hides it from others. Unconscious denial, where a woman is not aware she is pregnant, and on some occasions women can have a totally unexpected, sudden delivery.

It is the third of these types, which is by far the rarest, that has been much debated in France in recent weeks where it was cited in defence of a woman accused of murdering three of her children.

Lawyers for Veronique Courjault (41), the mother of two teenage sons, argued that it was a classic case of pregnancy denial.

The court in Tours heard how her husband, Jean-Louis Courjault, found the bodies of two babies in the freezer at the family’s home in the South Korean capital, Seoul, in the summer of 2006.

Ms Courjault, who was on holiday in France at the time, initially denied any knowledge of the babies. But after DNA tests proved she and her husband were the parents, she not only admitted giving birth to the two babies in 2002 and 2003 and then suffocating them, but also reported having had a previous baby in France in 1999, who she also killed.

Her husband did not know anything about the three pregnancies and has been cleared of any involvement in the deaths.

According to a BBC report, Courjault explained to investigators she and her husband had agreed they did not want any more children and that during her three subsequent pregnancies, she had felt no connection with the babies growing inside her. “I could not feel them move inside me,” she told psychiatrists. “As far as I was concerned they were never children. It was a part of myself, an extension of myself, that I was killing.”

Every year in France, 1,600-2,000 women apparently suffer from pregnancy denial, and at least 230 discover or admit they’re pregnant only at the moment they give birth, according to an article in Liberation newspaper.

These are not all naïve teenagers, as one might suppose, but often mothers of at least two children who are so opposed to the idea of having another child that they don’t show any physical symptom of their pregnancy.

Prof Veronica O’Keane, of the psychiatric unit in St James’s Hospital, in Dublin, says pregnancy denial is an extraordinary phenomenon. It is not classed as a psychiatric condition but she came across a number of cases in her previous job working in perinatal care in London.

There is a difference, she points out, between women who are in denial of their condition and those who are completely unaware of it.

Complete unawareness of pregnancy is “bizarre”, she says, but the brain does have a mechanism for switching off awareness of physiological experiences, she explains.

Women she has seen who gave birth in these circumstances had no history of psychiatric illness. They had absolutely no explanation for not knowing they were pregnant. “They are not always unwanted babies, which makes it more baffling,” says O’Keane.

She recalls one case where such unawareness occurred in two successive pregnancies. The first time the woman discovered she was pregnant only when she was in labour in the AE department of her local hospital. After marrying the father of that child, they were trying for a second baby but she still did not realise she had conceived until very late into her second pregnancy.

Catherine Conlon, social researcher at the Women’s Education, Research and Resource Centre in UCD, and author of the 2006 report entitled Concealed Pregnancy: A Case Study in an Irish Setting, was drawn to the subject after reading occasional newspaper reports of newborn babies being discovered. She looked at it from a social and cultural perspective. “There is a tendency to pathologise women who conceal their pregnancy,” she suggests. There is also a presumption that they don’t care about the wellbeing of their baby, whereas a lot of the reasons the 51 women she interviewed gave for not disclosing their pregnancy were social and cultural, she says.

Conlon has since helped to develop guidelines for health professionals on caring for women who conceal their pregnancy, which were launched in Galway last month.

These were designed to “put the woman’s perspective back into the frame”, she says, and to encourage those working in the health system to respond to their needs and avoid prejudging the issues.

Noreen and her parents, with whom she was living, had no time to prepare for the arrival of baby Aisling a year ago. Initially she did not want to keep the baby and a foster mother took care of her but Noreen was encouraged to visit.

Three weeks later Noreen shared the news of the birth with a friend – the first person to know after her parents and health professionals – because at that stage she was beginning to feel she wanted Aisling.

Once she made the decision, after four or five weeks, to keep her, she says it was “heartbreaking” to wait another couple of months, sorting out social welfare entitlements and accommodation, before they could be together full time. The father has no involvement in their lives. This Friday, she will celebrate Aisling’s first birthday with the now devoted grandparents. Noreen says she might even have a night out herself, to mark her first year of motherhood.

*Names of mother and baby have been changed to protect their privacy


For a list of services offering free, non-judgmental crisis pregnancy counselling, freetext the word LIST to 50444 or visit positiveoptions.ie